Cervical mucus sperm penetration in women on oral contraception or with an IUD

Abstract

Penetration of cervical mucus by spermatozoa was observed in cycling and infertile women, in women on sequential or combination oral contraceptive medication, and in women with an IUD in situ. _-Sperm penetration of cervical mucus varied from women not using contraceptives and from infertile women, to patients taking sequential conception control pills. In cycling women penetration was low in the early proliferative phase, high at mid-cycle, and low again in the luteal phase. The infertility patients, studied around mid-cycle, had high penetration. Patients on the sequential pill had moderate to high penetration throughout the cycle. Patients using IUD's had higher than anticipated sperm penetration, especially during the luteal phase of the cycle (p<O.O5), but also from Days 11-19, perhaps due to a local effect of the IUD on mucus production. Patients taking the low dose combination conception control pills had unexpectedly high penetration. During midcycle, when ovulation usually occurs, sperm penetration did not differ significantly from that in cycling women.

Genital tract infections associated with the intrauterine contraceptive device can be reduced by inserting the threads into the uterine cavity

“…This matter is controversial, but he supplies only references supporting his statement and fails to cite several papers indicating a spread of bacteria along the threads of an IUCD (Ansbacher & Campbell 1971;Batar et al 1988;Sparks et al 1981; Wolf & Krieger 1986). Dr Bromham also suggests that use of an IUCD thread retrieving instrument might lead to introduction of bacteria into the uterine cavity, but this suggestion is in no way substantiated.…”

Authors' reply

“…Dr Bromham also states that PID generally has a causal association with IUCD only in the first few weeks after insertion, presumably due to introduction of vaginal organisms with the device. This matter is controversial, but he supplies only references supporting his statement and fails to cite several papers indicating a spread of bacteria along the threads of an IUCD (Ansbacher & Campbell 1971; Batar et al 1988; Sparks et al 1981; Wolf & Krieger 1986). Dr Bromham also suggests that use of an IUCD thread retrieving instrument might lead to introduction of bacteria into the uterine cavity, but this suggestion is in no way substantiated.…”